RESUMEN
Clinical learning experiences are an essential part of nurse education programs. Numerous approaches to clinical education and student supervision exist. The aim of this integrative review was to explore how studies have compared or contrasted different models of undergraduate nurse clinical education. A search of eight databases was undertaken to identify peer-reviewed literature published between 2006 and 2015. Eighteen studies met the inclusion criteria. A diverse range of methodologies and data collection methods were represented, which primarily explored student experiences or perceptions. The main models of undergraduate nurse clinical education identified were: traditional or clinical facilitator model; the preceptorship or mentoring model; and the collaborative education unit model in addition to several novel alternatives. Various limitations and strengths were identified for each model with no single optimal model evident. Thematic synthesis identified four common elements across the models: the centrality of relationships; the need for consistency and continuity; the potential for variety of models; and the viability/sustainability of the model. The results indicate that effective implementation and key elements within a model may be more important than the overarching concept of any given model. Further research is warranted to achieve an agreed taxonomy and relate model elements to professional competence.
Asunto(s)
Competencia Clínica/normas , Bachillerato en Enfermería/métodos , Modelos Educacionales , Enseñanza/normas , Bachillerato en Enfermería/normas , Humanos , Preceptoría/tendencias , Estudiantes de EnfermeríaRESUMEN
The objective of this paper was to evaluate pre-registration nursing students' experiences of a pilot program that placed them in community based non-government organisations for clinical placement as part of a core mental health subject. Clinical placements that adopt a Service Learning model in primary health care environments are valuable to nursing students but are not commonly available in Australia. In order to enhance student exposure to primary health care models and support experiential learning about the social determinants of health, a pilot Service Learning program was designed to provide clinical placements in non-government organisations. Qualitative data were collected through one focus group with program participants. The focus group was audio-recorded and transcribed verbatim. Thematic analysis of transcribed data was undertaken. The overarching theme identified was 'new ways of seeing'. Three sub-themes - 'learning outside the box', 'confronting the real world' and 'transformative experiences' - were also identified. The authors have concluded that nursing students in community organisations for clinical practicum facilitated valuable learning and generated professional and personal insight leading to increased understanding of the social determinants of health and increased awareness of mental health nursing in the community.
Asunto(s)
Prácticas Clínicas , Aprendizaje Basado en Problemas/métodos , Enfermería Psiquiátrica/educación , Estudiantes de Enfermería , Australia , Bachillerato en Enfermería , Grupos Focales , Humanos , Proyectos Piloto , Investigación Cualitativa , Determinantes Sociales de la Salud , Estudiantes de Enfermería/psicologíaRESUMEN
INTRODUCTION: Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu OBJECTIVE: To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions. METHOD: A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature. DISCUSSION: Internationally, enabling undergraduate clinical learning opportunities faces a range of challenges. These can be illustrated under two broad themes: (1) legacies from the past and the inherent features of nurse education and (2) challenges of the present, including, population changes, workforce changes, and the disconnection between the health and education sectors. Responses to these challenges are triggering the emergence of novel approaches, such as collaborative models. CONCLUSION(S): Ongoing challenges in providing accessible, effective and quality clinical learning experiences are apparent.
Asunto(s)
Competencia Clínica , Bachillerato en Enfermería , Liderazgo , Aprendizaje Basado en Problemas , Tecnología Educacional , Humanos , Investigación en Educación de Enfermería , Estudiantes de EnfermeríaRESUMEN
BACKGROUND: Recognising and responding to patients who are deteriorating are key aspects to improving outcomes. Simulations provide students with exposure to deteriorating patient scenarios and the role of nurses in such events. The number of programmes seeking to provide best possible simulation experiences is growing exponentially. Robust evaluation of these experiences is crucial to ensure maximum benefit. OBJECTIVES: To assess the impact of a deteriorating patient simulation experience on students' technical and communication skills; and to determine if differing study programmes and years of previous nursing experience influenced students' responses and experiences. METHODS: A convenience sample of final year nursing students (N=57) in a medical-surgical course at a large urban university completed a descriptive pre/post simulation survey rating their technical skills and communication abilities in recognising and responding to patient deterioration. Changes in pre/post scores were analysed including influence of study programme (3-year, 2-year Enrolled Nurse, 2-year Graduate Entry); gender; and years nursing experience (beyond course clinical practicum). RESULTS: Statistically significant improvements in post-simulation survey scores were demonstrated for combined student group data. Students with greater years of nursing experience had statistically higher scores than those with less experience in both pre- and post-surveys. Specific improvements were identified for: assessing a deteriorating patient; and in seeking help from the medical officer or external service. CONCLUSIONS: All student groups gained benefit in participating in a deteriorating patient simulation. For this group, greater years of prior nursing experience led to higher pre- and post-survey scores. The learning activity provided students an experience of the importance of recognising and responding to an acute situation in a timely manner which may be recalled in subsequent clinical situations.
Asunto(s)
Evaluación en Enfermería , Personal de Enfermería/psicología , Poder Psicológico , Australia , Femenino , Humanos , Masculino , Índice de Severidad de la EnfermedadRESUMEN
To provide each student within a large cohort the opportunity to participate in a small group simulation that meets recognised quality indicators is a challenge for Bachelor of Nursing programmes in Australia. This paper, as part of a larger longitudinal study, describes one approach used to manage a simulation for 375 1st year nursing students and to report on the quality of the experience from the student's perspective. To ensure quality was maintained within the large cohort, aspects of the simulation were assessed against the following indicators: alignment with curriculum pedagogy and goals; preparation of students and staff; fidelity; and debriefing. Data obtained from a student focus group were analysed in the context of the quality indicators. The following themes emerged from the data: knowing what to expect; assuming roles for the simulation; authenticity and thinking on your feet; feeling the RN role; and, preparation for clinical practice. This paper demonstrates it is possible to provide students in large cohorts with active participatory roles in simulations whilst maintaining quality indicators.